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In response to a last-minute surge in health-insurance sign-ups, Covered California ​— ​the state’s arm of the Affordable Care Act, a k a Obamacare ​— ​gave a two-week deadline extension to anyone who started the enrollment process by March 31. In the last week alone, 156,000 state residents signed up for one of the many health-care networks mandated by the act, and more than 1.2 million have done so overall, which is about twice the initial goal set by Covered California. While no numbers exist specific to Santa Barbara County, the six counties making up the Central Coast saw 62,000 new enrollments. How many of those were uninsured prior is not known. In Santa Barbara, three new exchange plans were offered: Kaiser (which has a minimal presence in the county), Blue Cross, and Blue Shield.

Covered California also signed up an additional 1.5 million state residents for MediCal, including 11,539 in Santa Barbara County, although officials believe that up to 30,000 residents could qualify. Luckily, there’s no deadline for enrolling in MediCal, but it’s for naturalized U.S. citizens who make no more than 138 percent of the federal poverty level, or about $15,000 for individuals and $33,000 for a family of four.

Santa Barbara still has many Obamacare bugs to work out, particularly that Sansum Clinic, the largest health-care provider in the county, has no contract with Blue Shield, which could affect a small but significant slice of its patient population. Primary care providers are concerned at the low rates offered by the Blue Shield exchange; some have refused to accept those patients, and others have terminated their agreements with Blue Shield.

But the big news, according to County Health spokesperson Susan Klein-Rothschild, is that thousands of residents who weren’t covered before now are, so they can seek ongoing care rather than just descend upon emergency rooms en masse. “And that’s fantastic,” she said.

[As Botany notes above] The Issue is Access to Care, Not the Number Who Buy Insurance

Focusing solely on the number of people who are insured is what the private health insurance industry wants the public to believe is most important…

In the United States, having health insurance does not guarantee access to necessary health care. In fact, rather than creating health security, the ACA is degrading health care coverage in the US. It is also creating the largest transfer of public dollars to a private industry ever, as UNITE HERE reports “most of the ACA’s $965 billion in subsidies will go directly to commercial insurance companies.”...

…instead of creating a single standard of care, so that everyone has access to the health care they need, the ACA locked into law a tiered system of coverage…the upper tier plans are not any better than the lower tier plans in terms of what services are covered or where patients can go for care…

This is essentially a pay-now-or-pay-later scheme.

And it is a scheme, because there are no guarantees that people who have insurance will be protected from financial ruin if they have a serious health problem. It is essential to remember that nothing about the basic business model of insurance companies has changed…

One of their major work-arounds is the use of narrow and ultra-narrow provider networks to discourage patients with pre-existing conditions from buying their plans and leave patients footing more of the bill. Narrow networks exclude at least 30% of local hospitals and ultra-narrow networks exclude at least 70%. This means that if the local cancer center isn’t included in a plan, then people with cancer are unlikely to buy that plan...

The reason for the narrow networks is that when patients don’t go to an approved health provider, they bear most or all of the costs...

Medical bankruptcy and self-rationing, foregoing necessary care due to cost, are two products of our market-based health system and we can expect them to continue under the ACA…

And now that lower coverage plans are legal, they are accelerating the race to the bottom in employer health benefits. Employers are shifting more of the cost of health care onto employees, reducing coverage for dependents, moving employees into private insurance exchanges (which do not qualify for subsidies) and penalizing employees for poor health habits…

The Practical Solution

…Putting our money into the insurance industry is a step in the wrong direction. The Expanded and Improved Medicare for All Act, HR 676, in Congress, would eliminate the insurance industry and create lifelong comprehensive coverage for everyone...

The reason why "If you like your doctor, you can keep your doctor" was not true in about 3-?% of cases, was because those people had signed up for junk insurance plans. Under ACA they could not keep them, because they were junk - ACA sets the standard higher than junk.

Yes, we need Medicare for all, or single-payer, but after all of the hysterical loud-noise machine opposition to ACA, there was no hope in hell for Medicare for all to be implemented. ACA is probably not perfect, but children can get healthcare until 26, people with pre-existing conditions can get care, preventive medicine is free, etc.

If all politicians would work for the good of the country and not the good of their party, we would probably have Medicare for all.

"The reason why "If you like your doctor, you can keep your doctor" was not true in about 3-?% of cases, was because those people had signed up for junk insurance plans. Under ACA they could not keep them, because they were junk - ACA sets the standard higher than junk."

As someone who had his plan cancelled and offered an Obamacare plan, I can promise you the above statement is totally false. The plan I had was far from junk; in fact, it was much better than any of the plans on the state exchange. The premium for the Obamacare plan was $500 per month more than my existing plan; and it had a higher out of pocket maximum and most importantly the network of doctors and hospitals were about half of what I previously had access to. In addition, I use to have coverage for out of state providers and non-formulary drugs, both of which I lost when my plan was cancelled.

Most people (like the above poster) have no idea what is included in the Obamacare plans and end up saying ridiculous nonsense, demonstrating their ignorance of the subject.

"The ACA was designed specifically to prevent insurance companies from peddling lousy insurance plans and to force these firms to replace these subpar products with affordable plans providing better and effective coverage. The plans being canceled are ending because they offered insufficient coverage—and only a few years ago both Rs and Ds were upset about these kinds of plans. But there's been collective amnesia about the shoddy plans that GOPers have happily exploited in recent days. Perhaps Obama should have said, "Those of you who obtain insurance on the individual market can keep your plans unless it’s the sort of rip-off plan the ACA will forbid. Otherwise, you will be offered new options that actually give you decent coverage at a decent price.""http://www.motherjones.com/politics/2...

Sorry - that statement is 100% accurate, as can be found in multiple articles. E.g.

"The ACA preserves (with small but important improvements) the current system of health care financing for the vast majority of Americans: employer-based coverage, Medicare, and Medicaid. Those are the 94 percent of people with coverage for whom the “if you like it, you can keep it” promise is true.

For the 6 percent of insured who buy coverage on their own, the more accurate message would have been, “If you have good insurance and you like it, you can keep it.” The ACA reforms a corrupt individual insurance market. No longer can insurers turn people down due to a pre-existing condition or raise rates and drop people because they get sick. The ACA bans the sale of plans with such skimpy benefits and high-out-of-pockets costs that they are worthless if someone gets seriously ill."http://www.nationalmemo.com/the-origi...

As for a pharmacy going out of business because of Obamacare. Enrollment only ended Mar 31, and already (Apr 5) a pharmacy has been affected? That statement, I would suggest, is BS.

"People are receiving cancellation notices because they were sold health insurance policies that provide bare-bones coverage and expose them to financial ruin if they get sick or injured. Insurance companies sold these plans knowing full well that consumers could not keep them after the Affordable Care Act (ACA) standards are fully implemented on Jan. 1. The insurance companies didn't tell their clients that they couldn't keep the plans they sold them, and they certainly didn't tell them that the plans were junk. Now the Republicans want to allow the industry to continue to sell these policies for another year in the name of letting people keep the plans "they like." This is hypocrisy and politics at its worst, not to mention terrible policy."http://www.huffingtonpost.com/ethan-r...

Perhaps the outrage over ACA is a good thing if simply from the perspective that it forces people to actually *look* at their goddamn insurance, rather than just consuming it. Once you get past “destroy everything”, liberating the junk insurers is the only alternative plan the Republicans have – some not very states-rightsy plan to make health insurance magically competitive by pushing state insurance regulators out of the way. Then Rick Harebrain Perry can go back to San Francisco again to tell everyone, “Thanks to my small government policies, Texans can buy insurance for $10 per month!” (that policy covers one band aid per year). (in-network only).(with a $10 copay).Junk Insurance may have been the biggest scam ever perpetrated on the American people. Even bigger than The Great Hummel Depressionhttp://teensleuth.com/blog/?p=24018(this article has more detail, and is worth reading)

Ahhhh ---- the junk insurance that Republicans think is OK for people to have, and covers very little.

Most of these "junk" plans were far from junk. Many just excluded certain types of care. If I didn't want obstetric or mental health coverage, I didn't have to purchase it. With the ACA's one size fits all approach, I was force to have this coverage or my policy was labeled "junk". The insurance co's would them be forced to cancel my policy and I would be forced into a higher premium and deductible under the ACA.

my experience, and with friends on the exchange, is that most of the junk plans really were sh!t, and tabatha nails it. I agree JT that single-payer is the obvious way to go, but Republican and ostrich-stupidity made that impossible. How wonderful that millions now can afford health care insurance due to the ACA, despite all its issues. Lou… you forget to mention this part.

The argument that males should have access to plans that don't cover certain things (e.g. pregnancy) is shaky in my opinion. What about colonoscopies? Breast cancer? Yeast infections? Should I demand a cheaper policy that doesn't cover BRCA cancer because I'm not Jewish? Sickle cell anemia because I'm not African American? Mental health coverage because my family doesn't have a history of problems?

Individualized insurance polices tailored for one's own risk profile is probably appealing to libertarians, but goes against the concept of a shared risk pool.

Isn't insurance always covered based on someone's risk profile? If I have 2 DUI's and accident, should I pay the same as a driver with a clean record? I live in a high fire area of Mission Canyon. I wish some of you guys would subsidize my fire insurance. How about it?

Unlike some of the posters who think Obamacare plans are better than the individual plans that were sold in Ca, based on very biased articles from Mother Jones and Huffington Post, I actually had my policy cancelled so I think I know what I am talking about.

I use to have an individual policy with Blue Shield for my wife and me. It had a $5,200 deductible per person and a similar out of pocket maximum. It had a very robust network of providers, essentially covering every doctor and hospital in Ca, as well as most providers out of state. It had no lifetime or annual limits and all preventative care was free. It also covered non-formulary drugs. It cost me $679 a month

The Obamacare policy has a $5,000 deductible and $6,350 out of pocket maximum. The network of doctors and hospitals is pitifully small compared to what I had. None of my doctors take it. Sansum won't take it and UCLA or Cedar Sinai in LA won't take it. What good is the policy if I can't find a decent doctor or specialist to treat me if I get sick. If I need specialized care outside of Santa Barbara, I am screwed. The drug formulary is about 2/3 the size of the old one and it doesn't cover non-formulary drugs. So If i need an expensive drug for a serious condition, I am probably out of luck. This super duper Obamacare policy costs $1,110 a month, far more than my pre-Obamacare policy.

Now I know I wasn't the only one in the individual market who got screwed. Most people who didn't qualify for subsidies were shocked when their plans were cancelled and they were told the new sticker price. Yes, people who have employer health plans were unaffected but their time is coming when they have to face the same issues I dealt with in the last few months.

So please don't tell me I don't know what I am talking about. You can read your Mother Jones and other nonsense, but that doesn't mean you have any more than a superficial understanding of the subject. If you're going to defend this law at least educate yourselves as to what is really happening instead of repeating the political talking points of the partisan supporters.

and guess what lousegal, your insurer is probably still Blue Shield. It's not Obama cuz if it was it'd be called medicare. Health insurance has always been a scam, it's just that now they are able to rob the poor too. My insurance was cut in half, a friend's went from over $600 a month (pre-existing gotcha) to $120 a month. We both still have Blue Cross, same as before, and we still go through the same agent (middle man). Yes, it's bs, scam, but it always was. Especially when they double charge you or refuse to pay for your hospital bill. Happens all the time. When you let people play politics with health care, it's always lose lose except for the guy who collects the checks. The system was broken, admitted by all. One side offers stupid solution, other side sticks head in the sand, we all get played for money and political points, feeling healthy now?

Yes, maybe the insurer is still the same. But now, a 61 year old woman with Obamacare should rest easy now that she has obstetrical services covered under her new plan that she did have under the old plan. So what if the premium and deductible is much higher.

Gallup survey suggests sign-ups under ObamaCare not as high as White House says April 7, 2014

The Gallup-Healthways Well-Being Index measured the share of adults without health insurance. That shrank from 17.1 percent at the end of last year to 15.6 percent for the first three months of 2014.

The decline of 1.5 percentage points would translate roughly to more than 3.5 million people gaining coverage.

The administration says 7.1 million have signed up for subsidized private plans through new insurance markets, while 3 million previously uninsured people gained coverage through the law's Medicaid expansion.

Why the huge difference? For starters, the administration's numbers include people who switched or were dropped from their previous coverage, as well as people who have not paid their first month's premium, and who would therefore still be uninsured. The administration is also counting sign-ups dating back to October, though enrollment in the first few months was relatively low.

As the Obama administration continues to provide growing aid to Kenya, the U.S. will help subsidize a nationwide citizen-health assessment in every Kenyan county without exception.The estimated project cost still remains a mystery, however, a separate Kenya-based trade-promotion project unveiled late last week came with a price tag of an additional $70 million.With U.S. taxpayer help, the Kenya National Bureau of Statistics will implement the 2014 Kenya Demographic and Health Survey, or KDHS.The effort with Kenya will be coordinated with United Nations agencies, the U.S. government and “other partners.” The U.S. will fund a KDHS requirement that involves deploying contractor caravans across the East African nation of 45 million.The goal of the U.S. Agency for International Development’s is to facilitate the travel accommodations which will be necessary to conduct 45,000 household in-person health surveys of women aged 15-49 and men 15-54.The objective of the survey is to provide “demographic, socioeconomic and health data” that policymakers will leverage for future “planning, monitoring and evaluation.” This is according to procurement documents WND located via routine database research.The work will be spread across 1,600 geographic “clusters” and is expected to last 160 to 220 days. The project may begin as early as April 28